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ROLES FOR THE CICU TEAM FOR UNIT ROUNDS
ROLES FOR THE CICU TEAM FOR UNIT ROUNDS
The CICU has determined that we can better our rounds and ultimately our patient care by assigning specific roles to the residents. The benefit of this is that everyone has a task specific to that patient, there is little chance of missing pertinent patient information, the entire team is engaged and as a multidisciplinary group, we close the loop on that particular patient.
JUNIOR RESIDENTS HAVE A DISTINCT ROLE:
JUNIOR RESIDENTS HAVE A DISTINCT ROLE:
ORDER OF PRESENTATION:
ORDER OF PRESENTATION:
Presenting junior
Junior writing orders and is also the resident who is on call for that day
Junior checking and presenting labs
Junior assessing medications
Junior reads and interprets ECG’s
Senior residents will monitor junior resident’s presentations and ask questions.
Staff cardiologist will be monitoring senior residents and provide teaching opportunities as appropriate.
Junior resident presents history and system assessment on their own patient and fills out progress notes for that patient
Attending RN presents any concerns
Second resident goes over medications
Pharmacist discusses medications (medication changes, etc.)
Third resident analyzes ECG’s
Fourth resident goes over labs which should always be on Netcare by 0800 (if there are not enough residents, third resident can do ECGS and labs concurrently)
Fifth and last resident reviews the written orders, writes down all new and changed orders and provides the wrap-up for that patient. This is important as they are also on call that day so it is a benefit to them to really know the patient.
Team goes in to assess patient
Wrap up plan is given by “order writing” resident. Close the Loop and ask “Have we missed anything?“
THE TEAM
THE TEAM
The team works together on each patient therefore no one leaves the team rounds unless there is an emergency. The resident on call that day remains available to CICU even if there are patients to see in ER.
As a result of these distinct roles, the attending cardiologist can then follow up if the resident’s performance isn’t satisfactory as they will have received written documentation of “said roles”.
Junior residents will not write prescriptions and discharge orders for patients being discharged until rounds are done at that time, the junior resident responsible for that patient can go back and finish writing discharge/transfer orders.
Progress notes must be written daily during rounds or at the very least, before the team leaves for consult rounds.
Transfer orders for 1 East will be written in an appropriate time frame as there have been issues where the orders are obsolete by the time the patient is transferred requiring the resident to have to rewrite them.
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